Cocaine Abuse and Dependence

Abstract

Cocaine abuse and dependence constitute major health and social problems in the US and elsewhere. They are associated with a wide range of psychiatric and medical morbidity, including an increased risk of transmission of HIV.

The 2 major approaches to the treatment of cocaine abuse and dependence are psychosocial interventions and pharmacotherapy to reduce withdrawal and craving, and to ensure abstinence initiation and relapse prevention. These approaches are often combined to optimise outcome. Numerous medications have been tested in the treatment of cocaine dependence. To date, however, there is no conclusive evidence in support of any generally effective pharmacotherapy for cocaine craving, withdrawal or abstinence initiation. Therefore, the mainstay of treatment is the use of psychosocial interventions.